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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C * Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> ELECTRICAL PERHIT <br />D~EYTINE z 06/82/97eddition/atterat~on11:16 ~IT ~ z 97~4819 <br /> <br /> : ~/8~Z997 <br /> <br />WORK DESC : 2~A SERV I/PUMP PANEL <br /> <br />SITE ADDRFSS : CITY: MARION COUNTY <br /> B163 WIST STAYTON RD SE AM <br /> <br />CRO~S STREET : <br /> <br />PARCEL HUMSER : 58301-000 <br /> <br />OWNER NAMF <br /> <br />APPLICANT <br />NAME <br /> <br />: SHEPARD, THEODORE R & LOUISE ANN <br /> <br />PACIFIC COAST ELECTRIC INC <br />1425 E. SANTIAM STREET <br /> <br /> STAYTOH, OR <br /> PHONE : 769-767i <br /> <br />CONTRACTOR : PACIFIC COAST ELECTRIC INC <br /> PHONE : 769-7671 <br /> <br />E[FCTRICIAN : PACIFIC COAST ELECTRIC INC <br /> PHONE : 769-7671 <br /> <br />SUPV ELEC : GILLETTE ROBIN ALL. EH <br />PHONE : GILLETTE ROSIN ALLEN <br /> <br />97383 <br /> <br />OCCB: 0045933 <br /> <br />CONTRACTOR LICENSE: 24-192C <br /> <br />SUPERVISOR LICENSE: 36535 <br /> <br />Units Description Fee <br />1 Service/feeders up to 2~ amps 50.00 <br />] Pumps/irri§ation circles 40.00 <br />1 State surcharge 4.58 <br />1 Refund .00 <br /> <br /> Assessed fees : 94.58 <br /> Adjustments : <br /> Total fees : 94.50 <br /> PAYEE: PACIFIC COAST ELECTRIC INC Total payr~ents: 94.50 <br /> · Balance due <br />~ THIS PERfllT IS NON-TR~N~FER/L~.E ~iD EXPIRES 18~ ~Y5 F~ IS~ ~TE IF ~K HAS <br />~ TO .~ET ~L ~I~HTS ~ STATE L~ ~ H~I~ ~TY ~IH~9. UP~ <br /> ~IT~H ~t ~ SIX ~H ~T~I~ ~Y ~ ~ED; <br />......~ SIGHATURE oF ~PPLICAHT: <br /> <br /> OONDALO E WOOOLEY, MARION COUNTY ~[JILOIN~G OFFICIAL / BY HBULL <br /> <br /> <br />